Stress and Hair Loss

By Irene Rubinson Sullivan, Therapist and Clinical Trichologist and Suzanne Elkhechen, MA, Senior Trichologist, Energy Zone Wellness Center, Englewood Cliffs, NJ

Hair is more than just keratin — it is tied to our identity, selfexpression, and confidence. So, when you notice thinning, shedding, or bald patches, it can feel like the world is closing in. For many, hair loss brings a sense of helplessness, especially when tied to something as pervasive as stress.

Stress-related hair loss is not just a physical issue; it is emotional, cyclical, and sometimes overwhelming. For professionals working with clients experiencing hair loss, or for those navigating this challenge, understanding the connection between stress and hair health can provide clarity, relief, and solutions.

How Stress Impacts Hair: The Biological Fallout

You have likely heard the phrase "stress makes your hair fall out". While dismissing this as a cliché is easy, there is a strong biological basis for it. Stress triggers a cascade of physiological reactions that disrupt the normal hair cycle, often leading to noticeable thinning or shedding.

Telogen Effluvium (TE): Stressinduced Shedding

Think of your hair growth cycle as a factory. Most of the time, hair follicles are in the anagen (growth) phase, actively producing strong, healthy hair. A smaller number of follicles are resting (the telogen phase), waiting to shed old hairs before re-entering the growth phase.

However, when the body experiences intense physical or emotional stress, this delicate balance is thrown off. Stress floods the body with cortisol, the infamous stress hormone, which pushes more follicles into the resting phase. The result is a dramatic increase in hair shedding, known as TE. The silver lining? This is typically temporary. Once stress levels stabilize, hair regrowth resumes, though it may take months for clients to see noticeable improvement.

Alopecia Areata: When Stress and the Immune System Collide

In more severe cases, stress does not just disrupt the hair cycle, it activates the immune system to attack hair follicles directly. This condition, alopecia areata, often causes sudden, round patches of hair loss and is emotionally devastating for many. Unlike telogen effluvium, alopecia areata is more unpredictable and often requires medical treatment.

Stress Worsens Existing Hair Loss

Clients with underlying conditions like androgenetic alopecia (pattern baldness) may find that stress speeds up hair thinning. Cortisol and other stress-related hormones can intensify inflammation around hair follicles and exacerbate pre-existing issues, making hair loss appear worse.

The Psychological Toll of Hair Loss

Hair loss is as much an emotional battle as a physical one. Losing hair can feel like losing a piece of your identity, leading to feelings of anxiety, frustration, or even shame. Research confirms that people with alopecia experience lower self-esteem and poorer quality of life. Studies rank the emotional impact of alopecia areata higher than psoriasis or even melanoma.

This emotional toll creates a vicious cycle: stress causes hair loss, hair loss causes stress, and the cycle continues. Breaking this loop requires addressing stress-related hair loss's physical and emotional components.

Breaking the Cycle: What Can Be Done?

Stress-related hair loss can feel overwhelming, but the good news is that it is often manageable and, in many cases, reversible. Both clients and professionals can take actionable steps to regain control over hair health.

1. Education is Empowerment

One of the most powerful tools you can offer clients is knowledge. Explain how stress affects the hair cycle and reassure them that conditions like telogen effluvium are temporary. Understanding what is happening in their body can alleviate some of the fear and anxiety associated with sudden hair loss.

2. Stress Management for Hair Recovery

Managing stress is not just about emotional relief — it is about restoring balance in the body and creating an environment where hair can thrive. Here are a few strategies:

• Mindfulness-Based Stress Reduction: Practices like yoga, meditation, and guided breathing exercises have been scientifically proven to reduce cortisol levels and improve overall well-being.

• Acceptance and Commitment Therapy: This therapy helps individuals accept their feelings without judgment while focusing on behaviors aligned with their values. It is beneficial for breaking the emotional cycle of stress and hair loss.

• Everyday Relaxation Techniques: Encourage clients to find simple, stress-relieving activities that work for them, such as journaling, walking in nature, or deep breathing exercises.

3. Psychological Support for Emotional Healing

When stress or trauma is overwhelming, professional help can be life-changing. Therapies like Cognitive Behavioral Therapy or Eye Movement Desensitization and Reprocessing (EMDR) are highly effective in reducing stress and its physical manifestations, including hair loss.

4. Holistic, Collaborative Care

For professionals, teaming up with dermatologists, trichologists, and mental health experts can create a comprehensive care plan that addresses all aspects of hair loss. Combining medical treatments, such as topical solutions or immunotherapy, with stress-reduction techniques often produces the best results for both hair regrowth and emotional well-being.

The Role of Psychological Support in Hair Regrowth

Hair regrowth is not just about scalp treatments but also about mental health. Studies show that psychological interventions can significantly improve emotional well-being and hair health. For example:

• A study published in the British Journal of Dermatology (2021) found that mindfulness and acceptance-based therapies reduced distress in people with alopecia.

• Hypnotherapy has shown potential for reducing stress and, in some cases, encouraging hair regrowth.

By addressing the root causes of stress, these therapies help clients rebuild confidence and reclaim control over their hair and lives.

A Message of Hope for Clients and Professionals

Whether you are professional guiding clients through hair loss or someone experiencing it firsthand, remember this: Stress-related hair loss is common and manageable. With the right tools, knowledge, and support, you can break the cycle and restore hair and confidence.

For professionals, staying informed about the latest research and techniques is key. Continuing education and collaboration with other experts can deepen your understanding and help you provide the best care for your clients.

For clients, know that you are not alone, and a team of professionals is ready to help. Stress may be inevitable, but its effects on hair do not have to be permanent. By addressing hair loss's physical and emotional components, you can reclaim your peace of mind and sense of self.